Extracorporeal life support in paediatrics.

Pearson, Gale; Grant, Janie Busby; Field, David; Sosnowski, Andrzej; Firmin, Richard K.

doi:10.1136/adc.68.1.94

Cited by 11 publications

(4 citation statements)

References 13 publications

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“…Selecting patients with a high predicted mortality in whom lung disease is still reversible is critical to the intelligent use of ECMO. Similar to mechanical ventilation, ECMO does nothing to repair damaged lung tissue but only supports the organism during lung failure and (4,(9)(10)(11)(12)(13)(14)(15). However, the problems of case selection for ECMO and evaluation of the results are debatable.…”

Section: Discussionmentioning

confidence: 99%

“…However, the problems of case selection for ECMO and evaluation of the results are debatable. Even though two prospective, randomized, controlled studies have shown that ECMO treatment is superior to conventional treatment in the neonatal age group (16,17), there have been no trials in pediatric patients with respiratory disorders and only a few case reports in the literature, with no reports on long-term follow-up (15).…”

Section: Discussionmentioning

confidence: 99%

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Pediatric ECMO for pulmonary support: experience from 12 cases

et al. 1995

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Extracorporeal membrane oxygenation (ECMO), which can be described as treatment with a modified heart-lung machine over a prolonged period of time, is used to support patients with life-threatening but potentially reversible lung failure. ECMO by itself does not cure the patient but gives the lungs a chance to rest while awaiting spontaneous or therapeutic healing. The method is well documented in the neonatal age group. In the non-neonatal age group, however, experience is less extensive. This report of the initial result from our hospital with 12 non-neonatal pediatric cases shows high survival and low morbidity. Nine of the 12 patients were able to be weaned from ECMO (75% survival) and 8 of these 9 patients were long-term survivors. Medium time on the ventilator after discontinuation of ECMO was 4 days. At follow-up, all long-term survivors had no signs of neurological or pulmonary sequelae. These encouraging results point to the fact that ECMO should be considered more often in cases of life-threatening but potentially reversible pulmonary failure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pediatric ECMO for pulmonary support: experience from 12 cases

et al. 1995

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“…The resultant combination of raised left ventricular afterload and preload may lead to distension of the left heart, functional mitral regurgitation, and a risk of fatal pulmonary hemorrhage. 35 In the context of a venoarterial cannulation, conventional methods of assessing ductal shunts using Doppler techniques, are unreliable. In addition to systolic pulsatile shunting in either direction, a high volume, non-pulsatile, diastolic, left-to-right shunt from the extracorporeal circuit may still be present and its effects demonstrated by assessment of the ratio of left atrial and aortic dimensions.…”

Section: Significance Of the Arterial Ductmentioning

confidence: 99%

“…It is already apparent that, with appropriate case selection, extracorporeal life support can be far more successful than was previously envisaged in the treatment of older children and adults. 17…”

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confidence: 99%